Occurrence and etiology for subclinical mastitis in cows

Studied were a total of 16,571 cows on 89 farms by means of the Bernburg test. Milk was sampled from the positively reacting quarters of the udder by taking 18,047 samples intended for bacteriologic investigation. The demonstration of mastitis streptococci was carried out on "TKT" agar Merk, of pathogenic staphylococci, hemolytic streptococci, and Corinebacteria--on dextrose agar Oxoid containing 7.5% citrated calf blood. The isolated hemolytic streptococcus bacteria from the two nutrient media were differentiated through the CAMP test as well as serologically by the precipitation agar gel and Difco sera. The pathogenicity of Staphylococcus bacteria, in addition through hemolysis, was tested by the use of plasma coagulase with citrated rabbit plasma. In 53.95% of the cases there were secretory lesions due to Sc. agalactiae (6.23%) to Sc. dysgalactiae (5.69%) to Sc. uberis (8.47%), to Staph. aureus (2.44%), to hemolytic streptococci of the C, G and L groups (0.28%), to Sc. viridans (0.03%), to Corynebacterium pyogenes (0.41%), and catarrhal mastitis (30.4%). Some of the causative agents, such as Sc. agalactiae, Staph. aureus, and others have proved of epidemiologic importance to humans.     

Nosocomial pseudobacteremia. Positive blood cultures due to contaminated benzalkonium antiseptic

Pseudomonas cepacia or Enterobacter species or both were isolated from blood cultures of 79 patients in a community hospital between April 1971 and March 1972. No common exposures other than venipuncture correlated with positive blood cultures. Pseudomonas cepacia, Enterobacter, and other Gram-negative enteric bacteria were cultured from aqueous benzalkonium chloride used for skin antisepsis prior to ordinary and blood culture venipuncture. Contamination of blood cultures by organisms from the antiseptic most likely accounted for positive cultures in 35 to 38 patients (92%) with P cepacia. The remaining three patients had repeated blood cultures positive for P cepacia and circumstantial clinical evidence of bacteremia; they may have contracted disease through exposure to the contaminated antiseptic. Substitution of an iodine-alcohol antiseptic abruptly reduced the isolation of P cepacia and Enterobacter.     

Studies on the rod-coccus life cycle of Rhodococcus equi

In the present study all 19 Rhodococcus equi cultures isolated from horses and 19 of 22 R. equi cultures isolated from human patients displayed a rod-coccus life cycle after cultivation under defined growth conditions. A bacillary growth could be observed after cultivation of the bacteria in fluid media for 4 h at 37 degrees C, a coccoid morphology after cultivation of the bacteria for 24 h either on sheep blood agar plates or in fluid media. The different morphological features did not significantly influence the typability of the bacteria or the expression of surface proteins including 15-17 kDa virulence proteins. Studies on further surface characteristics revealed a relation between haemagglutinating properties, the surface hydrophobicity and adherence properties of the bacteria to HeLa cells. These properties seemed to be influenced by the cultivation conditions but not by the different morphological forms of the bacteria. A haemagglutination reaction, a hydrophobic surface and an enhanced adherence to HeLa cells could be observed with coccoid bacteria after cultivation in fluid media for 24 h at 37 degrees C but not with coccoid bacteria harvested from sheep blood agar plates or with bacillary bacteria after 4 h growth in fluid media. This difference might possibly be caused by the degree of encapsulation of the bacteria after various cultivation conditions and a subsequent masking effect of the hydrophilic polysaccharide capsule of R. equi.     

Comparison of axenic and monoxenic media for isolation of Acanthamoeba

Acanthamoeba is a genus of ubiquitous, free-living amebae that can be difficult to isolate by standard microbiologic techniques. We retrospectively reviewed the laboratory records of patients with ocular acanthamoebic infection for the period from January 1973 to June 1996 and found that Acanthamoeba isolates were recovered from 73, 71, and 70% of clinical specimens inoculated onto buffered charcoal-yeast extract agar (BCYE), nonnutrient agar with live or dead Escherichia coli, and tryptic soy agar (TSA) with horse or sheep blood, respectively. We then prospectively compared the recovery of a corneal isolate of Acanthamoeba on commercial media from Remel and BBL (TSA with 5% sheep blood, TSA with 5% horse blood, TSA with 5% rabbit blood, V agar, chocolate agar, BCYE, and selective BCYE with polymyxin B, anisomycin, and vancomycin) and on axenic and monoxenic media prepared with live or dead bacteria (Enterobacter aerogenes, E. coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Serratia marcescens, Staphylococcus aureus, and Stenotrophomonas maltophilia). Good recovery of trophozoites was obtained on BCYE, TSA with rabbit blood, TSA with horse blood, and Remel TSA with sheep blood. BBL TSA with horse blood or rabbit blood provided good recovery of cysts. All species of live or dead bacteria yielded good recovery of trophozoites; however, only nonnutrient agar with live P. aeruginosa, live E. aerogenes, or live S. maltophilia gave good recovery of cysts. TSA with either rabbit blood or horse blood, BCYE, and nonnutrient agar prepared with live P. aeruginosa, E. aerogenes, or S. maltophilia offer optimal recovery of Acanthamoeba.     

Heat resistance of Listeria monocytogenes by two recovery media used with and without cold preincubation

Three strains of Listeria monocytogenes were heat-treated at three temperatures in physiological saline by a capillary tube method. Recovery of heat-treated bacteria was performed on blood agar and on tryptose phosphate agar with ferric citrate and aesculin (TPA-FE). Both media were used in two ways: (1) incubation at 37 degrees C for 7 d, and (2) preincubation at 4 degrees C for 5 d in order to obtain repair of heat-injured bacteria, followed by incubation at 37 degrees C for 7 d. D and z values were determined. In both incubation procedures, better average recovery was obtained on blood agar than on TPA-FE. Thus, higher D values were recorded when blood agar was used. In most cases the differences were statistically significant. Repair at 4 degrees C of heat-injured bacteria occurred on both media but the proportions of repaired bacteria were higher on blood agar. The repair on this medium was generally reflected in higher D values for preincubated samples. Some significant differences in heat resistance were noted between the strains.     

Blood cultures. Comparative study with 7 known and 2 new nutrient media for the detection of aerobic and anaerobic microorganisms (author's transl)

The growth promoting properties of seven commercially manufactured and two recently developed culture media are compared according to a standardized method. The study is carried out alternately without and with the addition of 10% fresh human blood to the culture media. The carefully selected test strains include 20 species of bacteria and 2 species of yeasts which represent obligatory aerobic, facultative anaerobic and obligatory anaerobic microorganisms with quite different nutritional and atmospherical requirements. The 9 tested media are good enough for the purpose of culturing nonfastidious bacteria. However, most of the commercially prepared media failed to detect small inocula of very fastidious microbial agents, especially when no blood is added. Collectively, thiol broth is the most noneffective medium. The last but one is thioglycollate medium. Three culture media based on brain heart infusion formula prove to be effective. Those are the commercial brain heart dextrose and the two media recently developed by the authors, namely brain heart dipeptone (BHD) and brain heart dipeptone cysteine (BHDC). BHD is the most suitable medium for the detection of obligatory aerobic and facultative anaerobic fastidious microorganisms. BHDC detects anaerobic fastidious bacteria quite effectively. The other media, namely Columbia, trypticase soy, trypticase soy sucrose, and Rosenow are of limited value with regard to the detection of small inocula of fastidious microorganisms. The causes of the unsatisfactory results with different commercial media are discussed in detail. The authors point out to the possible use of hypertonic media in special cases. Properties that should be fulfilled by blood culture media are proposed.     

Changes in the subcellular localization of the Brn4 gene product precede mesenchymal remodeling of the otic capsule

Listeria monocytogenes blood agar (LMBA) was compared to Listeria selective agar based on lithium chloride and ceftazidime (LA) and to the Oxford and Palcam media recommended by ISO and IDF for the detection and enumeration of L. monocytogenes from foodstuffs and food-processing environments. LMBA is based on trypticase soy agar with the following additions: sheep blood (5%) and as selective agents lithium chloride (10 g/l), polymyxin B sulphate (10 mg/l) and ceftazidime (20 mg/l), whereas the selectivity of LA is based on lithium chloride (15 g/l) and ceftazidime (15 g/l). The media were compared in the detection of L. monocytogenes after enrichment from naturally contaminated foodstuffs (n = 423) and from food-processing environments (n = 93), and in the enumeration of the species from naturally contaminated foodstuffs (n = 287). LMBA was superior both to the standard media and to LA in detection after enrichment and also in enumeration, except in the case of fresh broiler cut samples. The overall sensitivities of the Palcam, Oxford, LA and LMBA media were 68%, 67%, 74% and 96% in detection after enrichment and 64%, 73%, 76% and 80% in the enumeration of the species from ready to eat foods. The superiority of LMBA is based on distinguishing L. monocytogenes from other Listeria species by detection of beta-hemolysis, whereas the other media gave false-negative results because of the overgrowth of Listeria spp. other than L. monocytogenes, especially in detection after enrichment. A more selective medium than LMBA would have been required for the enumeration of the species from samples with high levels of competitive bacteria other than Listeria spp. The results indicate the need for a more specific isolation medium for L. monocytogenes in addition to those recommended by ISO and IDF for both detection and enumeration. LMBA offers an alternative to be used in combination with either Palcam or Oxford as well as with LA.     

Phospholipid fatty acid profiles in selected members of soil microbial communities

Fatty acids derived from phospholipids and lipopolysaccharides were investigated from 33 taxonomically different organisms (bacteria, fungi and plant cells) known a priori to inhabit soil (except E. coli). The extended extraction procedure used, liberated non-ester-linked fatty acids in addition to ester-linked fatty acids, hydroxy substituted fatty acids in three different fractions. The amount of non-ester-linked fatty acids was as high as 70% of the total phospholipid fatty acids in some fungi and varied considerably in different organisms. The cis vaccenic acid constituted about 50% of phospholipid fatty acids in selected bacteria belonging to the alpha subclass of Proteobacteria. These fatty acids were not found in other selected organisms. A large amounts of branched chain fatty acids were found in various organisms. If the branching are localised on positions other than iso and anteiso they were strong indicators for gram positive bacteria. The cyclopropyl fatty acids are mainly localized in gram negative bacteria. The beta hydroxy fatty acid of the outer membrane are widespread among bacterial taxa and fungi. These fatty acids are not recommended to use as "signature" fatty acids for gram negative bacteria.     

Characterization of dapB, a gene required by Pseudomonas syringae pv. tabaci BR2.024 for lysine and tabtoxinine-beta-lactam biosynthesis

The dapB gene, which encodes L-2,3-dihydrodipicolinate reductase, the second enzyme of the lysine branch of the aspartic amino acid family, was cloned and sequenced from a tabtoxin-producing bacterium, Pseudomonas syringae pv. tabaci BR2.024. The deduced amino acid sequence shared 60 to 90% identity to known dapB gene products from gram-negative bacteria and 19 to 21% identity to the dapB products from gram-positive bacteria. The consensus sequence for the NAD(P)H binding site [(V/I)(A/G)(V/I)XGXXGXXG)] and the proposed substrate binding site (HHRHK) were conserved in the polypeptide. A BR2.024 dapB mutant is a diaminopimelate auxotroph and tabtoxin negative. The addition of a mixture of L-,L-, D,D-, and meso-diaminopimelate to defined media restored growth but not tabtoxin production. Cloned DNA fragments containing the parental dapB gene restored the ability to grow in defined media and tabtoxin production to the dapB mutant. These results indicate that the dapB gene is required for both lysine and tabtoxin biosynthesis, thus providing the first genetic evidence that the biosynthesis of tabtoxin proceeds in part along the lysine biosynthetic pathway. These data also suggest that L-2,3,4,5-tetrahydrodipicolinate is a common intermediate for both lysine and tabtoxin biosynthesis.     

Looking at homeopathy, by an allopath

A study was done to test the effectiveness of fecal occult blood as a screening test for invasive bacterial pathogens and as a substitute for the fecal leukocyte examination in adult and pediatric cases of acute diarrhea. United States citizens studying in Mexico and Mexican children, both with acute diarrhea had their stools cultured, examined for fecal leukocytes, and tested for occult blood. Using culture results as the criterion standard for detection of bacterial agents, and fecal leukocytes for diarrhea associated with diffuse colonic inflammation, occult blood was tested for its sensitivity, specificity, and predictive value using 2 x 2 tables. Analysis of the data found that occult blood negative samples were reliable indicators of a lack of invasive bacteria in both adult and pediatric patients (negative predictive values of 87% and 96%, respectively). Positive results for either test were not reliably predictive as indicators of invasive bacteria among adults. A positive occult blood test result was significantly more sensitive than a positive fecal leukocyte test result (79% versus 42%) in detecting invasive bacteria in the pediatric patients; however, the positive predictive value was only 24%. The fecal occult blood test is an uncomplicated, low-cost test that was reliable when giving a negative result in detecting a lack of invasive bacteria in adult and pediatric patients with diarrhea. In children, a positive result on a fecal occult blood test is sensitive but not specific in detecting invasive bacterial enteropathogens. These data also indicate that a commercially available test for occult blood represents a suitable alternative to microscopic examination of fecal samples for leukocytes obtained from patients with acute diarrhea.     

Growth characteristics and a novel method for identification (the WEE-TAB system) of Porphyromonas species isolated from infected dog and cat bite wounds in humans

Thirty-nine clinical isolates of Porphyromonas species recovered from infected cat and dog bite wounds in humans and eight American Type Culture Collection and National Collection of Type Cultures type strains were characterized by using the API ZYM system, the RapID ANA II system, and conventional biochemical methods. Growth characteristics on various agar media were compared. All strains grew on brucella blood agar supplemented with vitamin K1 and hemin and on brucella laked blood agar supplemented with vitamin K1 and hemin. In contrast, only 34% of strains grew on unsupplemented brucella blood agar, 62% grew on Columbia blood agar, and 70% grew on tryptic soy blood agar (the last three media did not contain vitamin K1 or hemin). The ability of the single-tube, triple-substrate WEE-TAB system to detect the preformed enzymes N-acetyl-beta-D-glucosaminidase, alpha-D-galactosidase, beta-D-galactosidase, alpha-fucosidase, trypsin-like activity, and chymotrypsin was evaluated. The WEE-TAB test results were easy to interpret; the WEE-TAB tests were more sensitive than the comparable tests with the API ZYM and RapID ANA II systems for the detection of alpha-D-galactosidase, beta-D-galactosidase, trypsin, and chymotrypsin, and the WEE-TAB tests accurately identified Porphyromonas species.     

Characteristic difference in gastrointestinal excretion of clarithromycin and roxithromycin

BACKGROUND: This paper describes trends in hospital activity, hospital admissions, and treatments for colorectal cancer on residents of the South Thames regions (population 8 million) between 1989-1993 against the background of the Calman Report on the future of cancer services in England and Wales. METHODS: The analyses are derived from UK hospital data, which are collected as finished consultant episodes (FCEs). These are defined as episodes "where a patient has completed a period of care under a consultant and is either transferred to another consultant or is discharged." Probability matching was used to derive patient-based records, matching FCEs to admissions. A total of 18,542 South Thames residents aged 40-99 were admitted for colorectal cancer between 1 January 1989 and 31 December 1993. Time trends were analysed for procedures, FCEs, admissions, and patient numbers by admission type (ordinary admissions and day case admissions). RESULTS: Between 1989 and 1993 inclusive colorectal cancer admissions doubled (98% increase p (trend) < 0.0001). These admissions were a result of a 6.4-fold increase in day case admissions and a 41% increase in ordinary admissions. The proportion of patients having a day case admission rose from 9% in 1989 to 18% in 1993 (p < 0.0001). Overall, 2894 (16%) patients had a day case admission; 1894 of these (65%) were also admitted as ordinary admissions. The number of FCEs and admissions per patient rose from 1.37 and 1.28 respectively in 1989 to 2.09 and 1.99 respectively in 1993. FCEs were between 5% and 8% higher than admissions over the five years. The number of ordinary (that is, overnight) inpatient admissions per patient rose from 1.23 to 1.41 over the five year period and day case inpatient admissions from 1.25 to 3.45. Chemotherapy accounted for 50% of the rise in day case admissions; colonoscopy and sigmoidoscopy were associated with a further 18%. Fourteen per cent of the increase in ordinary admissions was also because of chemotherapy. CONCLUSION: The monitoring of site specific trends in admission, treatments, and procedures on a population basis should be a core requirement of health authorities to inform needs assessment, resource allocation, and service planning. The rise in admissions and chemotherapy treatments have implications for drug costs, laboratory and inpatient services, monitoring, and clinical audit.     

Otitis media with perforation of the tympanic membrane: a longitudinal experimental study

Despite the high incidence and prevalence of otitis media, its pathogenesis is not thoroughly understood. In an effort to provide a better understanding of this disease, experimental animal models have been developed which corroborate the changes observed in humans. In this study a new factor was added: tympanic membrane perforation 1 week after Eustachian tube obstruction. Twelve cats were divided in 4 even groups, and sacrificed at 1 and 2 weeks, 1 and 3 months after perforation, and their temporal bones were studied. Findings revealed an early massive reaction of the mucoperiosteum with granulation and polypoidal tissue formation which filled a considerable portion of the middle ear cavity. Polypoidal changes involved the stapediovestibular joint, possibly explaining the cases of stapes fixation found at tympanomastoidectomy procedures for chronic otitis media. Cholesterol granulomas with the classic characteristics as described in humans were observed in all animals at 3 month periods. These were preceded by clefts in the effusions, at 1 month, containing red blood cells. These clefts were considered as probable precursors of cholesterol granuloma formation. The association of endolymphatic hydrops, round window membrane changes, and otitis media without purulent labyrinthitis was observed; however, it was felt that the paucity of animals precluded any definite conclusions.     

Effects of time-of-day and photoperiod phase shifts on voluntary ethanol consumption in rats

Two experiments were conducted to examine the circadian fluctuations in voluntary ethanol (ETOH) consumption in male Sprague-Dawley rats conditioned to consume ETOH in their homecage and exposed to photoperiod phase shifts equivalent to those experienced by humans. Using a maintenance concentration of 20% w/v ETOH, changes in homecage drinking in 42 rats were assessed after photoperiod phase shifts similar to those inducing "jet lag" in humans and after experimenter-induced "hangover." A single 8-hr photoperiod phase advance significantly increased ETOH intake for three consecutive days, and a single photoperiod phase-delay increased intake only on the day of the phase shift. Acute ETOH withdrawal significantly reduced the voluntary consumption of ETOH for two consecutive days. In a second group of 30 rats maintained to consume a lower concentration of 10% w/v ETOH, the long-term effects of "shift lag" initiated by repeated photoperiod phase shifting similar to those experienced by humans working under a rotating work schedule were examined. Significant increases in intake occurred over the 2-month testing period. The significant alterations in voluntary intake initiated by the shift work schedule was related to the significant changes in blood alcohol concentrations.     

In situ morphology of nitrifying-like bacteria in aquaculture systems

The in situ microbiota from several aquaculture facilities with active nitrification was examined by transmission electron microscopy of thin sections for the presence of bacteria that contained intracytoplasmic membranes characteristic of the nitrifying bacteria. Colonies of bacteria with the cellular morphology of a species of Nitrosomonas were found to be present in both the culture water and in the biological filter slime of a freshwater chinook salmon (Oncorhynchus tshawytscha) culture system. bacteria in the water possessed the normal nitrosomonas type of ultrastructure, whereas similar bacteria in the slime had an aberrant morphology due to multiple invaginations of the cell wall and cyto-membranes and a significantly greater number of ribosomes. These nitrosomonas-like bacteria lysed during enrichment in commonly used media. Bacteria with the morphology of species of Nitrosomonas and Nitrosococcus were also observed in colonies in the surface slimes of marine culture systems for striped bass (Morone saxatilis) and quahaug (Mercenaria mercenaria).     

Evaluation of BBL CHROMagar orientation medium for detection and presumptive identification of urinary tract pathogens

The microbiological performance of BBL CHROMagar Orientation medium and CPS ID2 agar was compared to that of Columbia agar with 5% sheep blood and MacConkey agar without crystal violet for the enumeration and presumptive identification of bacteria responsible for urinary tract infections. Of a total of 658 clinical urine specimens, 118 specimens yielded no growth, 402 specimens yielded growth with cell counts of > or = 10(5) CFU/ml, and 138 specimens yielded growth with cell counts of < 10(5) CFU/ml. Of the specimens with cell counts of > or = 10(5) CFU/ml, 163 were pure cultures and 239 were mixed cultures. A total of 266 Escherichia coli organisms were isolated on both chromogenic media, 260 were isolated on blood agar, and 248 were isolated on MacConkey agar. One strain (0.4%) failed to develop the expected pink color on CHROMagar Orientation medium, and 23 strains (8.7%) failed to develop the expected pink color on CPS ID2 agar. Enterococci (CHROMagar Orientation medium, n = 266; CPS ID2 agar, n = 265) produced small blue-green colonies on both chromogenic media. Fifty of the mixed cultures contained enterococci that were detected only on the chromogenic media. The Klebsiella-Enterobacter-Serratia (KES) and the Proteus-Morganella-Providencia (PMP) groups could be identified on both chromogenic media. Of 66 isolates of the KES group, 63 grew with the expected color on CHROMagar Orientation medium and 58 of 64 isolates grew with the expected color on CPS ID2 agar. Other microorganisms required further identification. The use of chromogenic medium formulations offers a time-saving method for the reliable detection, enumeration, and presumptive identification of urinary tract pathogens. One of the greatest advantages of these media is the easy recognition of mixed cultures.     

Bacterial Transport in Gas-Sparged Porous Medium

To improve the feasibility of soil-aquifer remediation using bioaugmentation, more efficient methods are needed to widely disperse pollutant-degrading bacteria in porous media. Under water-saturated conditions, bacteria readily adhere to soil particles, but under unsaturated conditions, bacteria preferentially accumulate at the air-water interface. Air sparging a saturated porous medium produces a mobile water interface that was hypothesized to facilitate bacterial transport. To investigate whether gas sparging increased bacterial transport relative to saturated-water conditions, the transport of three strains of bacteria and negatively charged microspheres of different relative hydrophobicities RH was measured in saturated and gas-sparged quartz-packed columns. Gas sparging increased (>60%) the bacterial transport in only one case (Pseudomonas fluorescens P17; RH = 27%). Transport of the other two strains were either unaffected by gas sparging (Mycobacterium vaccae JOB5; RH = 33%), or was reduced (Pseudomonas aeruginosa; RH = 75%) relative to water-saturated conditions. Microspheres were the most hydrophobic (RH = 98%) and the most retained of all particles under saturated conditions, but microsphere transport was unaffected by gas sparging. These preliminary results suggest that the effect of gas sparging on colloid transport is particle specific and not predictable from measurement of relative hydrophobicity.     

Helicobacter canis isolated from a dog liver with multifocal necrotizing hepatitis

On the basis of biochemical, phenotypic, and 16S rRNA analysis, a novel gram-negative bacterium, isolated from normal and diarrheic dogs as well as humans with gastroenteritis, has been recently named Helicobacter canis. A 2-month-old female crossbred puppy was submitted to necropsy with a history of weakness and vomiting for several hours prior to death. The liver had multiple and slightly irregular yellowish foci up to 1.5 cm in diameter. Histologically, the liver parenchyma contained randomly distributed, occasionally coalescing hepatocellular necrosis, often accompanied by large numbers of mononuclear cells and neutrophils. Sections of liver stained by the Warthin-Starry silver impregnation technique revealed spiral- to curve-shaped bacteria predominantly located in bile canaliculi and occasionally in bile ducts. Aerobic culture of liver was negative, whereas small colonies were noted on Campylobacter selective media after 5 days of microaerobic incubation. The bacteria were gram negative and oxidase positive but catalase, urease, and indoxyl acetate negative; nitrate was not reduced to nitrite, and the organism did not hydrolyze hippurate. The bacteria were also resistant to 1.5% bile. Electron microscopy revealed spiral-shaped bacteria with bipolar sheathed flagella. By 16S rRNA analysis, the organism was determined to be H. canis. This is the first observation of H. canis in active hepatitis in a dog and correlates with recent findings of Helicobacter hepaticus- and Helicobacter bilis-related hepatic disease in mice. Further studies are clearly warranted to ascertain whether H. canis-associated hepatitis is more widespread in canines as well as a cause of previously classified idiopathic liver disease in humans.     

Prostatitis

The laboratory diagnosis of acute bacterial prostatitis is straightforward and easily accomplished in clinical laboratories. Chronic bacterial prostatitis, and especially chronic idiopathic prostatitis (most often referred to as abacterial prostatitis), presents a real challenge to the clinician and clinical microbiologist. Clinically, the diagnosis of chronic idiopathic prostatitis is differentiated from that of acute prostatitis by a lack of prostatic inflammation and no "significant" (controversial) leukocytes or bacteria in the expressed prostatic secretions. Despite these diagnostic criteria, the etiology of chronic idiopathic prostatitis is unknown. While this review covers the entire spectrum of microbially caused acute prostatitis (including common and uncommon bacteria, viruses, fungi, and parasites) and microbially associated chronic prostatitis, a special focus has been given to chronic idiopathic prostatitis. The idiopathic syndrome is commonly diagnosed in men but is poorly treated. Recent data convincingly suggests a possible bacterial etiology for the condition. Provocative molecular studies have been published reporting the presence of 16S rRNA bacterial sequences in prostate biopsy tissue that is negative for ordinary bacteria by routine culture in men with chronic idiopathic prostatitis. Additionally, special culture methods have indicated that difficult-to-culture coryneforms and coagulase-negative staphylococci are present in expressed prostatic secretions found to be negative by routine culture techniques. Treatment failures are not uncommon in chronic prostatitis. Literature reports suggest that antimicrobial treatment failures in chronic idiopathic prostatitis caused by organisms producing extracellular slime might result from the virulent properties of coagulase-negative staphylococci or other bacteria. While it is difficult to definitively extrapolate from animal models, antibiotic pharmokinetic studies with a murine model have suggested that treatment failures in chronic prostatitis are probably a result of the local microenvironment surrounding the persistent focal and well-protected small bacterial biofilms buried within the prostate gland. These conclusions support the molecular and culture data implicating bacteria as a cause of chronic idiopathic prostatitis.     

Bacterial strains isolated from neutropenic patients and their resistance to antibiotics

BACKGROUND: Although Gram negative as well as Gram positive bacteria participate in febrile episodes of neutropenic patients, in particular recently the ratio of Gram positive bacteria is increasing. The objective of the present work was to investigate the incidence and antibiotic resistance of pathogenic bacterial agents in neutropenic patients. METHODS AND RESULTS: The presence of bacteria was investigated in 446 neutropenic patients hospitalized at the Haematological Clinic in 1995. Haemocultures (apparatus Bact/Alert 120, cultivation media Organon-Teknika) and urine were examined. The sensitivity for antibiotics was tested by the standard dilution micromethod. In blood most frequently Staphylococcus epidermidis was isolated (45.4%), coagulase-negative strains of Staphylococcus haemolyticus, Staphylococcus hominis and Staphylococcus saprophyticus (14.4%), Acinetobacter calcoaceticus-baumannii (complex 6.3%) and Pseudomonas aeruginosa (6.3%). In urine the following were detected: Staphylococcus epidermidis (36.5%), Enterococcus sp. (14.5%), Escherichia coli (13.1%), Enterococcus faecalis (11.6%) and Enterococcus solitarius (6.5%). In all strains resistance to antibiotics and chemotherapeutic drugs was assessed. CONCLUSIONS: Investigation of the frequency of different bacterial species, along with monitoring of the resistance is an essential prerequisite of initial antibiotic therapy of febrile episodes in neutropenic patients.